Provider Demographics
NPI:1790292118
Name:PASR, PLLC
Entity Type:Organization
Organization Name:PASR, PLLC
Other - Org Name:PEDIATRIC & ADOLESCENT SPECIALISTS OF ROCKWALL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:MATTHEW
Authorized Official - Last Name:SONNEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:214-771-3712
Mailing Address - Street 1:6435 S FM 549 STE 201
Mailing Address - Street 2:
Mailing Address - City:HEATH
Mailing Address - State:TX
Mailing Address - Zip Code:75032-6225
Mailing Address - Country:US
Mailing Address - Phone:214-771-3712
Mailing Address - Fax:214-771-3796
Practice Address - Street 1:6435 S FM 549 STE 201
Practice Address - Street 2:
Practice Address - City:HEATH
Practice Address - State:TX
Practice Address - Zip Code:75032-6225
Practice Address - Country:US
Practice Address - Phone:214-771-3712
Practice Address - Fax:214-771-3796
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-08
Last Update Date:2020-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ3871207QA0000X
TXK5213208000000X
TXL2797208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty
No207QA0000XAllopathic & Osteopathic PhysiciansFamily MedicineAdolescent MedicineGroup - Multi-Specialty